Breastfeeding in Cystic Fibrosis: A Systematic Review on Prevalence and Potential Benefits
Carla Colombo1,2, Gianfranco Alicandro1,2, Valeria Daccò1
1Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Cystic Fibrosis Center, 20122 Milan, Italy.
Insights
Breastfeeding rates are lower in cystic fibrosis (CF) infants. Current evidence is insufficient to confirm benefits of breastfeeding in CF patients for growth or lung health, necessitating further research.
Area of Science:
- Pediatrics
- Genetics
- Immunology
Background:
- Breastfeeding (BF) is the recommended infant feeding standard.
- The impact of BF on cystic fibrosis (CF) patient outcomes requires further investigation.
Purpose of the Study:
- To systematically review BF prevalence in CF patients.
- To evaluate the impact of BF on anthropometric and pulmonary outcomes in CF.
Main Methods:
- Systematic review of original articles from MEDLINE, Embase, and Cochrane Library up to December 2020.
- Included studies reported BF prevalence and/or association with anthropometric or pulmonary outcomes in CF.
- Nine observational studies were identified and analyzed.
Main Results:
- BF rates in CF patients are lower than in the general population (approx. 50-60% BF).
- Benefits of BF for anthropometric outcomes in CF patients beyond two months are unclear.
- Limited, inconsistent evidence suggests potential pulmonary benefits (reduced infections), but data are insufficient.
Conclusions:
- Current data are insufficient to conclude on the benefits of exclusive BF for anthropometric and pulmonary outcomes in CF.
- Further clinical trials are needed to evaluate BF promotion interventions in CF patients.
Abstract:
Breastfeeding (BF) is considered the normative standard of feeding for all infants. However, the impact of BF in patients with cystic fibrosis (CF) is not completely defined. Therefore, we conducted a systematic review to evaluate BF prevalence in the CF population and its impact on anthropometric and pulmonary outcomes. We searched MEDLINE, Embase and the Cochrane Library for original articles published in English up to 4 December 2020 that report the prevalence of BF and/or any measure of association between BF and anthropometric or pulmonary outcomes. Nine observational studies were identified (six retrospective cohort studies, one prospective cohort study, one survey and one case-control study within a retrospective cohort). The BF rate in CF patients is lower than that of the healthy population (approximately 50-60% of infants were breastfed at any time). The benefits in anthropometric outcomes of BF for >2 months in this at-risk population are unclear. A few relatively small studies suggest a potential benefit of BF in reducing lung infections, although data are inconsistent. The currently available data are insufficient to draw definite conclusions on the benefits of exclusive BF in anthropometric and pulmonary outcomes in CF. Clinical trials evaluating well-defined BF promotion interventions are needed.
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